Beruflich Dokumente
Kultur Dokumente
19
Purpose: In the nature of a substitute.
H. R. 1
1 Strike out all after the enacting clause and insert the
2 following:
3 SECTION 1. SHORT TITLE.
1 SEC. 3. REFERENCES.
4 ECONOMIC SERVICE
5 RESEARCH AND EDUCATION ACTIVITIES
11 ACCOUNT
12 PROGRAM ACCOUNT
20 ADMINISTRATION
21 BROADBAND TECHNOLOGY OPPORTUNITIES PROGRAM
18 COMMUNICATIONS
13 PROSECUTION PROGRAMS
7 CONSTRUCTION
8 DECOMMISSIONING FUND
9 For an additional amount for ‘‘Uranium Enrichment
10 Decontamination and Decommissioning Fund’’,
11 $390,000,000, to remain available until September 30,
12 2010, of which $70,000,000 shall be available in accord-
13 ance with title X, subtitle A of the Energy Policy Act of
14 1992.
15 SCIENCE
16 For an additional amount for ‘‘Science’’,
17 $330,000,000, to remain available until September 30,
18 2010.
19 TITLE 17—INNOVATIVE TECHNOLOGY LOAN
20 GUARANTEE PROGRAM
21 Subject to section 502 of the Congressional Budget
22 Act of 1974, commitments to guarantee loans under sec-
23 tion 1702(b)(2) of the Energy Policy Act of 2005, shall
24 not exceed a total principal amount of $50,000,000,000
25 for eligible projects, to remain available until committed:
77
1 Provided, That these amounts are in addition to any au-
2 thority provided elsewhere in this Act and this and pre-
3 vious fiscal years: Provided further, That such sums as are
4 derived from amounts received from borrowers pursuant
5 to section 1702(b)(2) of the Energy Policy Act of 2005
6 under this heading in this and prior Acts, shall be collected
7 in accordance with section 502(7) of the Congressional
8 Budget Act of 1974: Provided further, That the source of
9 such payment received from borrowers is not a loan or
10 other debt obligation that is guaranteed by the Federal
11 Government: Provided further, That pursuant to section
12 1702(b)(2) of the Energy Policy Act of 2005, no appro-
13 priations are available to pay the subsidy cost of such
14 guarantees: Provided further, That none of the loan guar-
15 antee authority made available in this Act shall be avail-
16 able for commitments to guarantee loans under section
17 1702(b)(2) of the Energy Policy Act of 2005 for any
18 projects where funds, personnel, or property (tangible or
19 intangible) of any Federal agency, instrumentality, per-
20 sonnel or affiliated entity are expected to be used (directly
21 or indirectly) through acquisitions, contracts, demonstra-
22 tions, exchanges, grants, incentives, leases, procurements,
23 sales, other transaction authority, or other arrangements,
24 to support the project or to obtain goods or services from
25 the project: Provided further, That none of the loan guar-
78
1 antee authority made available in this Act shall be avail-
2 able under section 1702(b)(2) of the Energy Policy Act
3 of 2005 for any project unless the Director of the Office
4 of Management and Budget has certified in advance in
5 writing that the loan guarantee and the project comply
6 with the provisions under this title: Provided further, That
7 for an additional amount for the cost of guaranteed loans
8 authorized by section 1702(b)(1) and section 1705 of the
9 Energy Policy Act of 2005, $8,500,000,000, available
10 until expended, to pay the costs of guarantees made under
11 this section: Provided further, That of the amount pro-
12 vided for Title XVII, $15,000,000 shall be used for admin-
13 istrative expenses in carrying out the guaranteed loan pro-
14 gram.
15 OFFICE OF THE INSPECTOR GENERAL
16 For necessary expenses of the Office of the Inspector
17 General in carrying out the provisions of the Inspector
18 General Act of 1978, as amended, $5,000,000, to remain
19 available until September 30, 2012, and an additional
20 $10,000,000 for such purposes, to remain available until
21 September 30, 2012.
79
1 ATOMIC ENERGY DEFENSE ACTIVITIES
2 NATIONAL NUCLEAR SECURITY ADMINISTRATION
3 WEAPONS ACTIVITIES
21 ROWING AUTHORITY.
6 GRAPHIC AREAS.—
4 TECHNOLOGY
3 RELATED EXPENSES
2 AMERICANS
15 SERVICE OPERATIONS
3 INFORMATION TECHNOLOGY
3 Cash payment’’;
4 (4) by striking subsection (g);
5 (5) in subsection (l), by striking ‘‘(a)(2)’’ and
6 inserting ‘‘(a)(1)(A)(ii)’’;
7 (6) in subsection (m), by striking ‘‘this section’’
8 and inserting ‘‘subsection (a)(1)’’;
9 (7) in subsection (n)—
10 (A) in paragraph (1), by striking ‘‘this sec-
11 tion’’ and inserting ‘‘subsection (a)(1)’’; and
12 (B) in paragraph (2), by striking ‘‘this sec-
13 tion’’ and inserting ‘‘subsection (a)(1)’’;
14 (8) in subsection (o)—
15 (A) in paragraph (1), by striking ‘‘this sec-
16 tion’’ and inserting ‘‘subsection (a)(1)’’;
17 (B) in paragraph (2), by striking ‘‘this sec-
18 tion’’ and inserting ‘‘subsection (a)(1)’’; and
19 (C) by striking paragraph (4); and
20 (9) by adding at the end the following new sub-
21 section:
22 ‘‘(p) DEFINITIONS.—In this section:
23 ‘‘(1) the term ‘Armed Forces’ has the meaning
24 given the term ‘armed forces’ in section 101(a) of
25 title 10, United States Code;
177
1 ‘‘(2) the term ‘civilian employee’ has the mean-
2 ing given the term ‘employee’ in section 2105(a) of
3 title 5, United States Code;
4 ‘‘(3) the term ‘medical transition’, in the case
5 of a member of the Armed Forces, means a member
6 who—
7 ‘‘(A) is in Medical Holdover status;
8 ‘‘(B) is in Active Duty Medical Extension
9 status;
10 ‘‘(C) is in Medical Hold status;
11 ‘‘(D) is in a status pending an evaluation
12 by a medical evaluation board;
13 ‘‘(E) has a complex medical need requiring
14 six or more months of medical treatment; or
15 ‘‘(F) is assigned or attached to an Army
16 Warrior Transition Unit, an Air Force Patient
17 Squadron, a Navy Patient Multidisciplinary
18 Care Team, or a Marine Patient Affairs Team/
19 Wounded Warrior Regiment; and
20 ‘‘(4) the term ‘nonappropriated fund instrumen-
21 tality employee’ means a civilian employee who—
22 ‘‘(A) is a citizen of the United States; and
23 ‘‘(B) is paid from nonappropriated funds
24 of Army and Air Force Exchange Service, Navy
25 Resale and Services Support Office, Marine
178
1 Corps exchanges, or any other instrumentality
2 of the United States under the jurisdiction of
3 the Armed Forces which is conducted for the
4 comfort, pleasure, contentment, or physical or
5 mental improvement of members of the Armed
6 Forces.’’.
7 (b) CLERICAL AMENDMENT.—Such section is further
8 amended in the section heading by inserting ‘‘and certain
9 property owned by members of the armed forces, depart-
10 ment of defense and united states coast guard civilian em-
11 ployees, and surviving spouses’’ after ‘‘ordered to be
12 closed’’.
13 (c) AUTHORITY TO USE APPROPRIATED FUNDS.—
14 Notwithstanding subsection (i) of such section, amounts
15 appropriated or otherwise made available by this title
16 under the heading ‘‘Homeowners Assistance Fund’’ may
17 be used for the Homeowners Assistance Fund established
18 under such section.
19 DEPARTMENT OF VETERANS AFFAIRS
20 VETERANS HEALTH ADMINISTRATION
21 MEDICAL SUPPORT AND COMPLIANCE
16 FACILITIES
16 SPECTOR GENERAL
17 For an additional amount for ‘‘Operating Expenses
18 of the United States Agency for International Develop-
19 ment Office of Inspector General’’ for oversight require-
20 ments, $500,000, to remain available until September 30,
21 2011.
193
1 TITLE XII—TRANSPORTATION AND HOUSING
2 AND URBAN DEVELOPMENT, AND RELATED
3 AGENCIES
4 DEPARTMENT OF TRANSPORTATION
5 OFFICE OF THE SECRETARY
6 SUPPLEMENTAL DISCRETIONARY GRANTS FOR A
6 EQUIPMENT
10 INVESTMENT
23 INVESTMENT
16 SHIPYARDS
1 TITLE XIII—HEALTH
2 INFORMATION TECHNOLOGY
3 SEC. 1301. SHORT TITLE.
12 ADOPTION.
16 MENT.—
24 NOLOGY.
23 LAW.
3 STANDARDS; REPORTS
6 TION SPECIFICATIONS.
4 AMENDMENTS
23 TECHNOLOGY TESTING.
16 GRAMS.
5 STRUCTURE.
4 MENTATION ASSISTANCE.
10 MATION TECHNOLOGY.
5 NOLOGY.
17 EDUCATION.
21 ON HEALTH CARE.
2 SECURITY PROVISIONS
6 SECURITY PROVISIONS.
6 (1) DEFINITION.—
7 (A) IN GENERAL.—Subject to subpara-
8 graph (B), for purposes of this section, the
9 term ‘‘unsecured protected health information’’
10 means protected health information that is not
11 secured through the use of a technology or
12 methodology specified by the Secretary in the
13 guidance issued under paragraph (2).
14 (B) EXCEPTION IN CASE TIMELY GUID-
17 VACY.
16 COVERED ENTITIES.
6 MAT.
26 (1) IN GENERAL.—
333
1 (A) IN GENERAL.—Subject to subpara-
2 graph (B), a covered entity shall be treated as
3 being in compliance with section 164.502(b)(1)
4 of title 45, Code of Federal Regulations, with
5 respect to the use, disclosure, or request of pro-
6 tected health information described in such sec-
7 tion, only if the covered entity limits such pro-
8 tected health information, to the extent prac-
9 ticable, to the limited data set (as defined in
10 section 164.514(e)(2) of such title) or, if needed
11 by such entity, to the minimum necessary to ac-
12 complish the intended purpose of such use, dis-
13 closure, or request, respectively.
14 (B) GUIDANCE.—Not later than 18
15 months after the date of the enactment of this
16 section, the Secretary shall issue guidance on
17 what constitutes ‘‘minimum necessary’’ for pur-
18 poses of subpart E of part 164 of title 45, Code
19 of Federal Regulation. In issuing such guidance
20 the Secretary shall take into consideration the
21 guidance under section 13424(c) and the infor-
22 mation necessary to improve patient outcomes
23 and to detect, prevent, and manage chronic dis-
24 ease.
334
1 (C) SUNSET.—Subparagraph (A) shall not
2 apply on and after the effective date on which
3 the Secretary issues the guidance under sub-
4 paragraph (B).
5 (2) DETERMINATION OF MINIMUM NEC-
24 (a) MARKETING.—
343
1 (1) IN GENERAL.—A communication by a cov-
2 ered entity or business associate that is about a
3 product or service and that encourages recipients of
4 the communication to purchase or use the product
5 or service shall not be considered a health care oper-
6 ation for purposes of subpart E of part 164 of title
7 45, Code of Federal Regulations, unless the commu-
8 nication is made as described in subparagraph (i),
9 (ii), or (iii) of paragraph (1) of the definition of
10 marketing in section 164.501 of such title.
11 (2) PAYMENT FOR CERTAIN COMMUNICA-
13 ENTITIES.
10 INFORMATION.—
3 PORTS
4 CATION.—
15 CIES.
5 EDUCATION.
4 State—
5 (A) will enhance the quality of academic
6 assessments described in section 1111(b)(3) of
7 ESEA (20 U.S.C. 6311(b)(3)) through activi-
8 ties such as those described in section 6112(a)
9 of such Act (20 U.S.C. 7301a(a));
10 (B) will comply with the requirements of
11 paragraphs (3)(C)(ix) and (6) of section
12 1111(b) of ESEA (20 U.S.C. 6311(b)) and sec-
13 tion 612(a)(16) of IDEA (20 U.S.C.
14 1412(a)(16)) related to the inclusion of children
15 with disabilities and limited English proficient
16 students in State assessments, the development
17 of valid and reliable assessments for those stu-
18 dents, and the provision of accommodations
19 that enable their participation in State assess-
20 ments; and
21 (C) will take steps to improve State aca-
22 demic content standards and student academic
23 achievement standards consistent with
24 6401(e)(1)(A)(ii) of the America COMPETES
25 Act.
379
1 (5) will ensure compliance with the require-
2 ments of section 1116(a)(7)(C)(iv) and section
3 1116(a)(8)(B) with respect to schools identified
4 under such sections.
5 SEC. 1406. STATE INCENTIVE GRANTS.
25 (a) IN GENERAL.—
380
1 (1) ELIGIBLE ENTITY.—For the purposes of
2 this section, the term ‘‘eligible entity’’ means—
3 (A) A local educational agency; or
4 (B) a partnership between a nonprofit or-
5 ganization and—
6 (i) one or more local educational agen-
7 cies;
8 (ii) or a consortium of schools.
9 (2) PROGRAM ESTABLISHED.—From the total
10 amount reserved under section 1401(c), the Sec-
11 retary may reserve up to $650,000,000 to establish
12 an Innovation Fund, which shall consist of academic
13 achievement awards that recognize eligible entities
14 that meet the requirements described in subsection
15 (b).
16 (3) BASIS FOR AWARDS.—The Secretary shall
17 make awards to eligible entities that have made sig-
18 nificant gains in closing the achievement gap as de-
19 scribed in subsection (b)(1)—
20 (A) to allow such eligible entities to expand
21 their work and serve as models for best prac-
22 tices;
23 (B) to allow such eligible entities to work
24 in partnership with the private sector and the
25 philanthropic community; and
381
1 (C) to identify and document best practices
2 that can be shared, and taken to scale based on
3 demonstrated success.
4 (b) ELIGIBILITY.—To be eligible for such an award,
5 an eligible entity shall—
6 (1) have significantly closed the achievement
7 gaps between groups of students described in section
8 1111(b)(2) of ESEA (20 U.S.C. 6311(b)(2));
9 (2) have exceeded the State’s annual measur-
10 able objectives consistent with such section
11 1111(b)(2) for 2 or more consecutive years or have
12 demonstrated success in significantly increasing stu-
13 dent academic achievement for all groups of stu-
14 dents described in such section through another
15 measure, such as measures described in section
16 1111(c)(2) of ESEA;
17 (3) have made significant improvement in other
18 areas, such as graduation rates or increased recruit-
19 ment and placement of high-quality teachers and
20 school leaders, as demonstrated with meaningful
21 data; and
22 (4) demonstrate that they have established
23 partnerships with the private sector, which may in-
24 clude philanthropic organizations, and that the pri-
382
1 vate sector will provide matching funds in order to
2 help bring results to scale.
3 SEC. 1408. STATE REPORTS.
2 SISTANCE.
6 In this title:
7 (1) AGENCY.—The term ‘‘agency’’ has the
8 meaning given under section 551 of title 5, United
9 States Code.
10 (2) BOARD.—The term ‘‘Board’’ means the Re-
11 covery Accountability and Transparency Board es-
12 tablished in section 1511.
13 (3) CHAIRPERSON.—The term ‘‘Chairperson’’
14 means the Chairperson of the Board.
15 (4) COVERED FUNDS.—The term ‘‘covered
16 funds’’ means any funds that are expended or obli-
17 gated—
18 (A) from appropriations made under this
19 Act; and
20 (B) under any other authorities provided
21 under this Act.
22 (5) PANEL.—The term ‘‘Panel’’ means the Re-
23 covery Independent Advisory Panel established in
24 section 1531.
387
9 (a) CHAIRPERSON.—
10 (1) DESIGNATION OR APPOINTMENT.—The
11 President shall—
12 (A) designate the Deputy Director for
13 Management of the Office of Management and
14 Budget to serve as Chairperson of the Board;
15 (B) designate another Federal officer who
16 was appointed by the President to a position
17 that required the advice and consent of the
18 Senate, to serve as Chairperson of the Board;
19 or
20 (C) appoint an individual as the Chair-
21 person of the Board, by and with the advice
22 and consent of the Senate.
23 (2) COMPENSATION.—
24 (A) DESIGNATION OF FEDERAL OFFI-
23 (a) FUNCTIONS.—
389
1 (1) IN GENERAL.—The Board shall coordinate
2 and conduct oversight of covered funds in order to
3 prevent fraud, waste, and abuse.
4 (2) SPECIFIC FUNCTIONS.—The functions of
5 the Board shall include—
6 (A) reviewing whether the reporting of con-
7 tracts and grants using covered funds meets ap-
8 plicable standards and specifies the purpose of
9 the contract or grant and measures of perform-
10 ance;
11 (B) reviewing whether competition require-
12 ments applicable to contracts and grants using
13 covered funds have been satisfied;
14 (C) auditing and investigating covered
15 funds to determine whether wasteful spending,
16 poor contract or grant management, or other
17 abuses are occurring;
18 (D) reviewing whether there are sufficient
19 qualified acquisition and grant personnel over-
20 seeing covered funds;
21 (E) reviewing whether personnel whose du-
22 ties involve acquisitions or grants made with
23 covered funds receive adequate training; and
390
1 (F) reviewing whether there are appro-
2 priate mechanisms for interagency collaboration
3 relating to covered funds.
4 (b) REPORTS.—
5 (1) QUARTERLY REPORTS.—The Board shall
6 submit quarterly reports to the President and Con-
7 gress, including the Committees on Appropriations
8 of the Senate and House of Representatives, summa-
9 rizing the findings of the Board and the findings of
10 inspectors general of agencies. The Board may sub-
11 mit additional reports as appropriate.
12 (2) ANNUAL REPORTS.—The Board shall sub-
13 mit annual reports to the President and the Com-
14 mittees on Appropriations of the Senate and House
15 of Representatives, consolidating applicable quarterly
16 reports on the use of covered funds.
17 (3) PUBLIC AVAILABILITY.—
13 THORITIES.
9 ADVISORY PANEL.
22 VISERS.
Sec. 1231. Deferral and ratable inclusion of income arising from indebtedness
discharged by the repurchase of a debt instrument.
Sec. 1251. Increased exclusion amount for commuter transit benefits and tran-
sit passes.
Sec. 1501. De minimis safe harbor exception for tax-exempt interest expense of
financial institutions.
Sec. 1502. Modification of small issuer exception to tax-exempt interest expense
allocation rules for financial institutions.
Sec. 1503. Temporary modification of alternative minimum tax limitations on
tax-exempt bonds.
Sec. 1504. Modification to high speed intercity rail facility bonds.
Sec. 1801. Prohibition on collection of certain payments made under the Con-
tinued Dumping and Subsidy Offset Act of 2000.
420
Subtitle J—Other Provisions
Sec. 1901. Application of certain labor standards to projects financed with cer-
tain tax-favored bonds.
Sec. 1902. Increase in public debt limit.
Sec. 1903. Election to accelerate the low-income housing tax credit.
20 CREDIT.
9 ALTY.—
2 PLOYMENT COMPENSATION.
12 CREDITS.
20 SOURCES.
19 PRODUCTION CREDIT.
11 ERTY.
10 SMART METERS.
15 SEARCH.
17 CREDITS.—
5 INJECTANT.
7 VEHICLES
7 PROPERTY.—
14 NESS ASSETS.
2 LOSSES
7 OPERATING LOSSES.—
20 2009 OR 2010.—
17 INSTRUMENT.
5 FRINGE BENEFITS
8 PASSES.
5 DEMULTIPLEXING EQUIPMENT.—Multiplexing
18 TURE.—
4 CHANGE
10 PROPERTY.
5 ERGY FACILITIES.
18 CREDIT.
5 PROJECT.—
2 ‘‘(a) ALLOCATIONS.—
3 ‘‘(1) IN GENERAL.—The Secretary shall allo-
4 cate the national recovery zone economic develop-
5 ment bond limitation and the national recovery zone
6 facility bond limitation among the States—
7 ‘‘(A) by allocating 1 percent of each such
8 limitation to each State, and
9 ‘‘(B) by allocating the remainder of each
10 such limitation among the States in the propor-
11 tion that each State’s 2008 State employment
12 decline bears to the aggregate of the 2008
13 State employment declines for all of the States.
14 ‘‘(2) 2008 STATE EMPLOYMENT DECLINE.—For
12 BONDS.
17 BOND.—
14 EXEMPT BONDS
17 INSTITUTIONS.
13 BONDS.
2 FACILITY BONDS.
12 TORS
14 ON GOVERNMENT CONTRACTORS.
13 ISSUER.
6 FAVORED BONDS.
10 Subtitle A—Unemployment
11 Insurance
12 SEC. 2001. EXTENSION OF EMERGENCY UNEMPLOYMENT
13 COMPENSATION PROGRAM.
10 BENEFITS.
15 TION.
8 VANCES.
8 CREASES.—
16 TERM BENEFITS.—
4 AND SERVICES.
17 INCENTIVE PAYMENTS.
Sec. 3301. Premiums and cost sharing protections under Medicaid, eligibility
determinations under Medicaid and CHIP, and protection of
certain Indian property from Medicaid estate recovery.
Sec. 3302. Rules applicable under Medicaid and CHIP to managed care entities
with respect to Indian enrollees and Indian health care pro-
viders and Indian managed care entities.
Sec. 3303. Consultation on Medicaid, CHIP, and other health care programs
funded under the Social Security Act involving Indian Health
Programs and Urban Indian Organizations.
Sec. 3304. Application of prompt pay requirements to nursing facilities.
Sec. 3305. Period of application; sunset.
3 THEIR FAMILIES.—
4 (1) PROVISION OF PREMIUM ASSISTANCE.—
17 (i) IN GENERAL.—Notwithstanding
6 SISTANCE.—
19 FECT ON COVERAGE.—
20 PREMIUM ASSISTANCE.—
19 ANCE (TMA).
23 (QI) PROGRAM.
22 HEALTH PROGRAMS.—
21 CARE ENTITIES.
19 VIDERS.—
21 CENTERS.—
15 SUPPLEMENTAL PAYMENT.—Nothing
9 INDIAN ORGANIZATIONS.
6 TO NURSING FACILITIES.
Sec. 4211. Medicaid provider EHR adoption and operation payments; imple-
mentation funding.
9 ‘‘(A) IN GENERAL.—
22 CENTIVE PAYMENTS.—
11 FORMATION EXCHANGE.—
24 ‘‘(A) ADJUSTMENT.—
680
1 ‘‘(i) IN GENERAL.—Subject to sub-
2 paragraphs (B) and (D), with respect to
3 covered professional services furnished by
4 an eligible professional during 2015 or any
5 subsequent payment year, if the eligible
6 professional is not a meaningful EHR user
7 (as determined under subsection (o)(2)) for
8 a reporting period for the year, the fee
9 schedule amount for such services fur-
10 nished by such professional during the year
11 (including the fee schedule amount for pur-
12 poses of determining a payment based on
13 such amount) shall be equal to the applica-
14 ble percent of the fee schedule amount that
15 would otherwise apply to such services
16 under this subsection (determined after ap-
17 plication of paragraph (3) but without re-
18 gard to this paragraph).
19 ‘‘(ii) APPLICABLE PERCENT.—Subject
15 MENTS.—
4 MENTS.—
12 SCRIBING.—
3 FORMATION EXCHANGE.—
2 MENTS.—
13 MENTS.—
2 TION FUNDING.
22 (a) STUDY.—
23 (1) IN GENERAL.—The Secretary of Health and
24 Human Services shall conduct a study to determine
25 the extent to which and manner in which payment
717
1 incentives (such as under title XVIII or XIX of the
2 Social Security Act) and other funding for purposes
3 of implementing and using certified EHR technology
4 (as defined in section 1848(o)(4) of the Social Secu-
5 rity Act, as added by section 4311(a)) should be
6 made available to health care providers who are re-
7 ceiving minimal or no payment incentives or other
8 funding under this Act, under title XVIII or XIX of
9 such Act, or otherwise, for such purposes.
10 (2) DETAILS OF STUDY.—Such study shall in-
11 clude an examination of—
12 (A) the adoption rates of certified EHR
13 technology (as so defined) by such health care
14 providers;
15 (B) the clinical utility of such technology
16 by such health care providers;
17 (C) whether the services furnished by such
18 health care providers are appropriate for or
19 would benefit from the use of such technology;
20 (D) the extent to which such health care
21 providers work in settings that might otherwise
22 receive an incentive payment or other funding
23 under this Act, title XVIII or XIX of the Social
24 Security Act, or otherwise;
718
1 (E) the potential costs and the potential
2 benefits of making payment incentives and
3 other funding available to such health care pro-
4 viders; and
5 (F) any other issues the Secretary deems
6 to be appropriate.
7 (b) REPORT.—Not later than June 30, 2010, the
8 Secretary shall submit to Congress a report on the find-
9 ings and conclusions of the study conducted under sub-
10 section (a).
11 SEC. 4206. STUDY ON AVAILABILITY OF OPEN SOURCE
13 TEMS.
14 (a) IN GENERAL.—
15 (1) STUDY.—The Secretary of Health and
16 Human Services shall, in consultation with the
17 Under Secretary for Health of the Veterans Health
18 Administration, the Director of the Indian Health
19 Service, the Secretary of Defense, the Director of
20 the Agency for Healthcare Research and Quality,
21 the Administrator of the Health Resources and Serv-
22 ices Administration, and the Chairman of the Fed-
23 eral Communications Commission, conduct a study
24 on—
719
1 (A) the current availability of open source
2 health information technology systems to Fed-
3 eral safety net providers (including small, rural
4 providers);
5 (B) the total cost of ownership of such sys-
6 tems in comparison to the cost of proprietary
7 commercial products available;
8 (C) the ability of such systems to respond
9 to the needs of, and be applied to, various pop-
10 ulations (including children and disabled indi-
11 viduals); and
12 (D) the capacity of such systems to facili-
13 tate interoperability.
14 (2) CONSIDERATIONS.—In conducting the study
15 under paragraph (1), the Secretary of Health and
16 Human Services shall take into account the cir-
17 cumstances of smaller health care providers, health
18 care providers located in rural or other medically un-
19 derserved areas, and safety net providers that deliver
20 a significant level of health care to uninsured indi-
21 viduals, Medicaid beneficiaries, SCHIP beneficiaries,
22 and other vulnerable individuals.
23 (b) REPORT.—Not later than October 1, 2010, the
24 Secretary of Health and Human Services shall submit to
25 Congress a report on the findings and the conclusions of
720
1 the study conducted under subsection (a), together with
2 recommendations for such legislation and administrative
3 action as the Secretary determines appropriate.
4 Subtitle B—Medicaid Funding
5 SEC. 4211. MEDICAID PROVIDER EHR ADOPTION AND OPER-
7 ING.
10 UNEMPLOYMENT.—
11 (1) IN GENERAL.—Subject to subsections (e),
12 (f), and (g), if a State is a qualifying State under
13 paragraph (2) for a calendar quarter occurring dur-
14 ing the recession adjustment period, the FMAP for
15 the State shall be further increased by the number
16 of percentage points equal to the product of the
17 State percentage applicable for the State under sec-
18 tion 1905(b) of the Social Security Act (42 U.S.C.
19 1396d(b)) after the application of subsections (a)
20 and (b) and the applicable percent determined in
21 paragraph (3) for the calendar quarter (or, if great-
22 er, for a previous such calendar quarter, subject to
23 paragraph (4)) .
24 (2) QUALIFYING CRITERIA.—
734
1 (A) IN GENERAL.—For purposes of para-
2 graph (1), a State qualifies for additional relief
3 under this subsection for a calendar quarter oc-
4 curring during the recession adjustment period
5 if the State is 1 of the 50 States or the District
6 of Columbia and the State satisfies any of the
7 following criteria for the quarter:
8 (i) An increase of at least 1.5 percent-
9 age points, but less than 2.5 percentage
10 points, in the average monthly unemploy-
11 ment rate, seasonally adjusted, for the
12 State or District, as determined by com-
13 paring months in the most recent previous
14 3-consecutive month period for which data
15 are available for the State or District to
16 the lowest average monthly unemployment
17 rate, seasonally adjusted, for the State or
18 District for any 3-consecutive-month pe-
19 riod preceding that period and beginning
20 on or after January 1, 2006 (based on the
21 most recently available monthly publica-
22 tions of the Bureau of Labor Statistics of
23 the Department of Labor).
24 (ii) An increase of at least 2.5 per-
25 centage points, but less than 3.5 percent-
735
1 age points, in the average monthly unem-
2 ployment rate, seasonally adjusted, for the
3 State or District (as so determined).
4 (iii) An increase of at least 3.5 per-
5 centage points for the State or District, in
6 the average monthly unemployment rate,
7 seasonally adjusted, for the State or Dis-
8 trict (as so determined).
9 (B) MAINTENANCE OF STATUS.—If a
10 State qualifies for additional relief under this
11 subsection for a calendar quarter, it shall be
12 deemed to have qualified for such relief for each
13 subsequent calendar quarter ending before July
14 1, 2010.
15 (3) APPLICABLE PERCENT.—For purposes of
16 paragraph (1), the applicable percent is—
17 (A) 2.5 percent, if the State satisfies the
18 criteria described in paragraph (2)(A)(i) for the
19 calendar quarter;
20 (B) 4.5 percent if the State satisfies the
21 criteria described in paragraph (2)(A)(ii) for
22 the calendar quarter; and
23 (C) 6.5 percent if the State satisfies the
24 criteria described in paragraph (2)(A)(iii) for
25 the calendar quarter.
736
1 (4) MAINTENANCE OF HIGHER PERCENTAGE
4 FECT.—
14 MENTS.—
18 2008’’;
18 WORKLOAD PROJECT.
9 SPECTOR GENERAL.
3 NOMIC DOWNTURN.
14 GOVERNANCE.
23 PENSATION.
22 RECIPIENTS.
19 IZED.